Marketplace | Sarah Alvarezhttp://www.marketplace.org/author/50081/feed.xml
Sarah Alvarez is a producer and reporter at Michigan Radio where she works on the State of Opportunity project. enHealth care for foster youth, if they can find ithttp://www.marketplace.org/topics/health-care/health-care-foster-youth-if-they-can-find-it

Just a few months ago health care navigators wanted desperately to get young people to sign up for the Affordable Care Act. There was an all-out advertising blitz aimed towards young people between the ages of 18 and 34 to get them to sign up for health insurance.

More than 6 hours of Obamacare commercials on YouTube? That smells like desperation.

But it seems like everybody forgot something. Not LeBron James, not Zak Galifianakas, and not JLo's mom or the other famous people who made commercials for Obamacare mentioned the part of the law that lets young people who aged out of foster care sign up for extended Medicaid, and keep it until age 26.

Kimberly Waller researches the ACA and foster care. She says the provision came about as an issue of fairness. "Advocates started realizing hey, what happens when the state's your parent?" she says.

When the state is your parent, you should now be able to get on their plan -- that's Medicaid -- until age 26. But states don't have to do any outreach about the provision. Waller says many young people don’t know they’re eligible, and that, "a right is only empowering if you know about it."

Kamille Tynes aged out of foster care in Michigan. She’s 23 now and in college. She’s good at navigating the ins and outs of government programs. Even she found the process confusing.

That would be the heathcare.gov. Every state is different, but in Michigan, kids who age out of foster care need to apply for healthcare through the agency that runs foster care. (It's not an intuitive process. If you need it, here are tips and a more detailed walk through the application).

For her part, Tynes just kept trying to apply. "I was told how you mention that you were in the foster care system and you aged out," she says. But, "I got denied."

She's not really sure why that happened, because she does qualify. Tynes just wants to go to the doctor and not rack up debt to do it. Former foster care youth like her have a lot more health care needs than others their age. But Tynes hasn't been to the doctor in over two years.

In Michigan, foster care advocates are working to draw attention to the glitches in the sign up process. Tynes did end up getting some help on her application from an advocate she knows.

It made a difference. Kamille Tynes sighs and says she's "finally!" insured. But she also laughs happily as she mimes holding her new health insurance card up high. She's already made her first doctor's appointment.

People aren’t leaving in droves. It’s more like a steady drip. Over the last decade, the schools here have lost about 350 kids, which is pretty typical for a rural district these days.

But each of those students takes about $7,000 in state aid with them -- so the district’s budget has taken a $2.5 million hit.

"Unfortunately, it came to this," Heidrich says.

The plan is to close the middle school, moving some of those kids to the high school, and some to the elementary. Heidrich says it’s worth it to help the school district avoid a deficit. When a school system is in deficit, the state can -- and has -- stepped in to take it over, or shut the whole thing down.

"We have to take care of our students, and we can’t wait on the state. There’s no guarantee of increased funding in the future. So, we have to take care of our own," Heidrich says.

The irony? The schools are better now, even though money is tighter. They already outperform some of the bigger, richer districts nearby. Despite the whole budget crunch, people in Stockbridge are trying to stay positive. There is anger, but gym teacher Steffe says it’s directed outward.

"I know everybody here is working hard for the most part. You wonder what the state of Michigan is doing to education. It doesn’t make any sense to me," he says.

Right around the corner from the middle school, at a small table in the village coffee shop, Chris Young is working on his laptop and taking a few calls. Young has a daughter in the district schools and says he’s willing to pay more in taxes if the district asks.

"You have to take care of your house-so to speak-or it will fall down around you," says Young. "This is a sleeper community. Nobody’s coming to Stockbridge, so you have to have people who are committed to putting their kids first. And I see a lot of that going on."

And like Stockbridge, there are many small towns across America where the population is shrinking, and the schools along with them.

]]>Sun, 26 Jan 2014 00:51:18 GMTTeenagers who could sign up for Medicaid, but don'thttp://www.marketplace.org/topics/economy/health-care/teenagers-who-could-sign-medicaid-dont

Michigan's governor, Rick Synder, is on a trade mission to Asia. But as soon as he gets back, he plans to sign his state's Medicaid expansion bill into law. After a long fight over Obamacare, the state will offer Medicaid to nearly 500,000 low-income adults starting in late March or early April 2014.

But the question is: Will these folks take advantage of this benefit? In Michigan, like many states around the country, there are large numbers of teenagers who could be signed up for Medicaid. But they aren’t.

Earlier this year, Jacquise Purifoy was laid off from her job as an attorney. Until about two months ago, she and her daughter went without health insurance.

“You know, I don’t know,” she says. “I guess I just buried my head in the sand a little bit, which was dangerous.”

Purifoy probably could have enrolled her 17-year-old daughter Jasmine up for Michigan’s Medicaid programs, but she didn’t. She was too proud and says she would have felt guilty about trying to access Medicaid. She was also hopeful her private insurance from the new job would kick in soon.

Then she got a call from Jasmine, who has asthma and a heart condition.

“When she called me from school saying, 'You have to get me now,' I knew that it was urgent,” Purifoy recalls. “I knew I didn’t have health insurance; it was really life or death. Am I going to let this child die, essentially, or am I going to get a god-awful bill? And of course I’m going to choose protecting my daughter.”

Luckily, nothing was going on with Jasmine’s heart. But it cost around $1,800 to find that out. Purifoy is paying off the bill in monthly installments, and Jasmine now has health insurance.

But across the country there are hundreds of thousands of teenagers eligible for Medicaid that aren’t insured. It’s a trend providers like Lori Partin are familiar with.

“When they get to a certain age it doesn’t become as important to them or maybe to their parent or guardian to keep the insurance up,” she says. “They seem to be healthy they don’t really need the medical care.”

Partin works at The Corner Health Center, a health clinic for adolescents in Ypsilanti, Mich.

Some families might be able to work more and make more money as their kids age, so that they don’t need Medicaid. Some of it could be parent confusion about age and income limits. There are also requirements to re-enroll every year.

Jaquise Purifoy says if she could talk directly to other parents, this is what she’d say, “Hey, this resource is available. Regardless of what you may be going through, your children deserve health insurance. It can save your life.”

It can save your life, and Purifoy says, it will save you a lot of money.

Kai Ryssdal: Among the few indisputable economic truths about 21st century America is this one: Manufacturing in this country just isn't what it used to be. Millions of jobs have disappeared, thousands of factories, as well. Even so -- with everything that's disappeared -- a lot of us still know what those factories looked like. Thanks to the late, great Mr. Fred Rogers.

Sarah Alvarez reports.

Sarah Alvarez: When I was a kid I was fascinated with Mr. Rogers’ factory tours. I loved watching how things were made, like trumpets and shoes and flashlights.

Mr. Rogers:I’d like to show you some people making crayons. Come along, I have a film of it here.

These places were full of metal equipment and conveyer belts lit by florescent lights. They were also full of people. I wanted to know how the factories in some those videos are doing now.

In 1998, Mr. Rogers visited Hedstrom Entertainment in Ashland, Ohio, to find out how people make a basic plastic ball. When he was there the factory was bustling. But as Mr. Rogers would ask:

Mr. Rogers: What’s happening now?

Jim Braeunig: Well, you know, we moved our factory to China in 2004 out of just sheer need.

That’s Jim Braeunig. He runs Hedstrom Entertainment.

Braeunig: Wages and things had gotten to the point -- and benefits -- that really made it impossible to compete with the Chinese product.

Braeunig says he did what he could for years to keep his factory in the U.S. We’re talking automation, increased efficiency and cutting a million dollars a year in costs.

Braeunig: It still wasn’t enough, long term, to support a domestic factory.

In the end, Braeunig was only able to keep his headquarters and a small industrial plastics business in Ohio.

He says the real problem with making toys in the U.S is this: People expect things to be cheap. When the toy factory closed, people were only willing to pay around 99 cents for the basic ball. That’s less than people paid for the same ball in 1967. Braeunig says he just can’t make products for that price here anymore.

There is a factory using the same process and the same space Mr. Rogers saw in 1985. It’s in Oak Park, Ill.

Trolley dings

Mr. Rogers: OK, we'll put the film in picture-picture and see how people make bass violins in a factory.

The factory is Link Bass and Cello. Everything in the woodshop is covered in sawdust, and there are parts of stringed instruments everywhere.

Tom Link: It’s old school.

Tom Link is the owner.

Link: They're just, they're amazed that you're still around as an instrument maker because we are a dwindling number.

Link’s business is hanging on. But his production is down about 80 percent. Staff is down too, from around 15 to 3 people. Because these days, almost all cellos are made in China. Link’s company has adjusted. It now concentrates on selling more expensive upright basses. Small manufacturers of specialty products have done better over the last decade. But, Link says, something else is important. As Mr. Rogers explained, an upright bass is really big.

Mr. Rogers: You see, it’s about as tall as a mom or a dad.

With oil prices high, shipping anything big from China gets expensive. Tom Link says these shipping costs have saved his business. In fact, his is one of the few factories from the Mr. Rogers videos still around.

But there is hope for new factories. Wallace Hopp is a manufacturing expert. He says certain types of products should still be made here in the U.S.

Wallace Hopp: High tech, you know, you’d see things like medical devices. Or things that you’re trying to match supply with volatile demand, things that are sort of hot for a week. Those kinds of things make sense to make locally.

The kinds of factories Mr. Rogers visited are pretty much a thing of the past. But if they’re lucky, Americans can find manufacturing work making a new generation of products.

Mr. Rogers: It takes so many people who care to make things work well, doesn’t it?